Measles death toll plummets

A global plan developed in 1999 to halve the number of deaths from measles by the end of 2005 looks set to reach its target.

A health survey reveals that fatalities had dropped nearly 40% by 2003, after a long campaign to promote vaccination by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).

The most recent results from the effort reveal that the estimated number of measles deaths fell from 873,000 in 1999 to 530,000 in 2003. It has taken two years to compile and analyse the data, which came from dozens of countries. The biggest impact was seen in Africa, where experts believe measles deaths decreased by 46%.

Although measles is now rare in industrialized countries, it remains common in many developing nations and currently affects more than 30 million people each year. The disease can leave them with disabilities such as brain damage and blindness.

Children who are not immunized, particularly those who do not receive sufficient amounts of vitamin A, face the greatest threat from measles. And yet vaccination is relatively cheap, costing only about 15 US cents a dose.

Before the campaign, most vaccination programmes gave children just one opportunity to be immunized, when they were nine months old. For the many children who missed that, there was no second chance. And 10% of children who do get immunized need a second dose the following year to achieve full protection against the disease.

The WHO and UNICEF's campaign encouraged governments to develop national vaccination days and strengthen routine programmes, which has now ensured that many more kids get that second chance.

Eager for action

Brad Hersh, the measles coordinator at the WHO in Geneva, believes that countries became particularly eager to take action against measles after seeing the disease completely eliminated in other areas of the world. "What really changed things is that many countries saw the experience of the Americas," says Hersh.

The WHO and UNICEF are confident that they will hit their target of reducing measles deaths to fewer than 440,000 by the end of this year. A panel of experts will meet soon to set a new goal for the initiative.

"The challenge is going to be to keep it up," says Diane Griffin, a measles expert and chair of the n immunologist at Johns Hopkins University in Baltimore, Maryland.

She and others have expressed concern about the rising number of parents in industrialized nations who refuse to vaccinate their children. In Japan, for example, immunization is no longer mandatory. "These are becoming individual decisions," explains Griffin.

In Britain, a purported link between autism and a vaccine against measles, mumps and rubella caused a significant decrease in immunizations. Follow-up studies have found no such connection, but measles vulnerability is on the rise. "This is a lamentable situation," says Hersh.